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I trained as a surgeon with the top experts in the field during my residency and fellowship and even today to enhance my practice offerings. Yet, I find myself writing more and more these days. I just completed updating the content on my website at http://www.mdface.com/ and am in the process of creating a new website that will be devoted entirely to the topic of revision rhinoplasty. I have vowed to update my blogs regularly to provide helpful and interesting information to my patients, and have become an active medical expert on http://www.realself.com/ to answer consumers’ questions about facial plastic surgery procedures. These answers are also posted to my Twitter account, which you are invited to follow @DrPearlman. As for my offline activities, I teach facial plastic surgery to residents from Columbia University and have a post residency fellow currently in my practice. I also present regularly on facial plastic surgery, including primary and revision rhinoplasty at meetings held by the American Academy of Facial Plastic and Reconstructive Surgery.

I am a firm believer that teaching helps me reach more patients than I can actually touch. In fact, one of the oldest definitions of physician is teacher. Residents and fellows seek out information from many sources. In order to be a useful resource for residents and fellows, it is important that I stay ahead of the game in terms of patient education and advances in the field. Last, but certainly not least, I firmly believe it is my responsibility to educate consumers. We are in an era of information, sometimes more information that we know what to do with. Patients should be educated about treatment options available to them as well as detailed information about the procedure(s) they are interested in, including the expected results and recovery time, whether the procedure is surgical or applied. An informed patient is the best kind of patient. If you have any questions related to this blog or would like to make a comment, I welcome you to do so.

We are now in the cyber age. People communicate by email, text, phone, fax and sometimes even in person. The same is true for cosmetic surgery. Many of my patients find me and other plastic surgeons through the internet; from a direct search, forums, and specialty directed services from qualified board searches such as the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and the American Board of Facial Plastic Surgery (ABFPRS). Therefore we receive requests for consultations, and frequently operate on patients from around the country as well as Europe, South America and Africa. Patients inquire about many of our services, especially rhinoplasty, revision rhinoplasty, surgical facial rejuvenation, facial fillers and laser treatments for the face. To facilitate this process, we offer initial phone consultations for potential patients if geographically necessary. Of course, nothing substitutes for a face to face conversation and evaluation in person.

How do we conduct a phone consultation? First and foremost, once a physician and patient begin a dialogue about potential treatment, they have engaged in a doctor-patient relationship. This is why all discussions are accompanied by a disclaimer that any and all advice given prior to a personal consultation is merely a suggestion and should not be taken as conclusive medical advice prior to a personal evaluation. In order to make this a meaningful process, we may request photographs and a patient information sheet to be filled out. We also request a signed consent to confirm that any recommendations for treatment are supposition and predicated on a personal consultation and evaluation.

For example, to properly evaluate someones nose for rhinoplasty, I really need to touch the nose to determine the strength of the underlying cartilage, feel the thickness of the skin and look inside the nose to see if there are any structural abnormalities, such as a deviated septum. So, any opinions I give over the phone, even with photos, need to be confirmed or altered by a personal evaluation. I love computer imaging, especially for primary rhinoplasty. However, I won’t image a patient that I haven’t seen. Computer imaging can be fairly accurate, but I also need to feel the nasal structures to see how much I can alter a nose before this process. So if you really want imaging, you must come to my office. I also suggest you steer clear of anyone who will offer imaging without an examination.

For out of town patients interested in revision rhinoplasty; I try to be as helpful as possible when evaluating them through photographs, but a personal examination is even more important. I may even defer a phone consultation when multiple surgeries have been performed or I find it too difficult to suggest potential reconstruction based on the photos and information given. I hope these patients understand the increasing complexity of revision surgery and that a personal exam is even more important.

For long distance patients, we prefer seeing them prior but given travel restrictions, I need to see them at least the day before surgery to assure that we are planning the appropriate procedure. This also gives them time to relax prior to surgery and reduces other potential complications from travel then immediate surgery under anesthesia. As a general idea, plan on staying in New York for about 7 to 8 days after surgery before returning home. We also provide concierge services and can help with hotel arrangements. More on this will be in my next blog.

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